Becoming parents again: Challenges affecting grandparent primary caregivers raising their grandchildren

The mediating role of childhood maltreatment in the association between being left-behind and adolescent anxiety

BACKGROUNDS

Left-behind and separated from parents are common among Chinese adolescents and many developing countries, which may cause maltreatment and mental disorders, especially anxiety. Nevertheless, the comprehensive study in the prevalence of childhood maltreatment and its role in anxiety among left-behind adolescents is still insufficient.

METHODS

A nationally representative middle school sample of 32,620 adolescents participated the pen-paper survey regarding demographics, left-behind status and the source of abuse. The Generalized Anxiety Disorder-7 and Chinese version of the Childhood Trauma Questionnaire were used to assess anxiety symptoms and maltreatment experience. The analyses in prevalence, risk factors and mediating effects were preformed in SPSS 27.

RESULTS

30,174 valid questionnaires were collected, of which 2748 were left-behind adolescents. 46.4 % of left-behind and 35.6 % of non-left-behind adolescents reported anxiety, and left-behind increased risk of anxiety (OR = 1.180, 95%CI: 1.180-1.286, p < 0.001). In left-behind adolescents, female sex, older age, and maltreatment experience were risk factors of anxiety. Additionally, left-behind adolescents were more likely to suffer serious abuse and all abuse subtypes. The maltreatment almost completely mediated the association between left-behind and anxiety (0.857, 95%bootstrap CI = 0.743, 0.976), of which emotional abuse played the largest role (0.648, CI = 0.547, 0.751), followed by physical neglect, emotional neglect, and sexual abuse.

CONCLUSION

This study revealed the prevalence of anxiety and maltreatment in Chinese left-behind adolescents, and suggested that the maltreatment might significantly mediate the anxiety of left-behind adolescents. This may shed a light on other developing countries where the phenomenon of left-behind adolescents exists.

Parental Substance Use Disorder and the Rise in Children Being Raised by Grandparents: Focusing on Children's Needs and Improving Outcomes

The occurrence of children being raised solely by their grandparents has steadily risen in the past decade prompted by parental substance use disorder (SUD) and associated incarceration and death. These families, especially children, are a vulnerable population with unique needs. Nurses should be cognizant of the needs, risk factors, and protective factors often associated with this population. Meanwhile, the literature to date mostly focuses on grandparents. School and pediatric nurses, specifically, are in an advantageous position to help support these families and help foster better child outcomes. The purpose of the current article is to explore the experiences, needs, and resources for supporting children being raised by grandparents due to parental SUD. Best practices for health care professionals, especially nurses, are discussed as well as future directions for research with this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, 62(12), 9-16.].

Intergenerational care and rural childhood obesity in the digital era: Based on screen exposure perspective

Background

Rural Chinese children are experiencing increasing obesity rates, yet studies often neglect the impact of IT and screen media growth on obesity risks in the context of intergenerational care, leading to incomplete strategies for the digital era.

Methods

By comprehensively utilizing the data on rural children aged 6-17 from the China Family Panel Studies (CFPS) and the China Health and Nutrition Survey (CHNS), this study aims to test the logical chain and specific mechanisms regarding "intergenerational care - screen exposure - rural childhood obesity". We employ the Propensity Score Matching (PSM) and Generalized Propensity Score Matching (GPSM) methods to respectively address the self-selection biases associated with inter-generational care and children's screen exposure behaviors.

Results

1) Intergenerational care significantly increases screen exposure among rural children. 2) Gender bias increases the risk of screen exposure for rural boys under intergenerational care. 3) Children with higher screen exposure levels are more affected by intergenerational care, which further undermines parental supervision. 4) Children's screen exposure leads to increased sedentary time and higher probability of purchasing unhealthy foods, thereby exacerbating obesity. This process is facilitated by enhancing preferences for snacks, fast food, and beverages, and weakening preferences for physical activity. 5) GPSM analysis indicates that children's screen exposure has an inverted "U"-shaped impact on unhealthy dietary preferences and a "U"-shaped impact on activity preferences. It results in a nonlinear positive impact of screen exposure on obesity. This study reveals a positive association between screen exposure and obesity, offering new insights into how intergenerational care in the digital era may elevate obesity prevalence through excessive screen time for rural children.

Association between personality traits and psychological distress among postmenopausal women with coronary heart disease: A cross-sectional survey and mediation analysis

Postmenopausal women with negative personality characteristics are at an increased risk of psychological disorders, yet little is known about the mechanism underlying the relationship between type D personality and psychological distress in postmenopausal women with coronary disease. This study assessed the mediating roles of perceived social support and self-perceived burden in the relationship between type D and psychological distress based on the equity theory and stress-buffering model. Demographic characteristics, type D, psychological distress, perceived social support, and self-perceived burden were completed by 335 participants with self-reported questionnaires using a cross-sectional design in Southeast China. The results revealed that perceived social support and self-perceived burden both separately and serially mediated the relationship between type D personality and psychological distress. Effective intervention strategies aimed at improving perceived social support or reducing self-perceived burden may be beneficial in reducing psychological distress.

Feasibility and Acceptability of an ABCD Program for Child Development Among Skipped Families in Rural Thailand: A Pilot Study

Introduction

The study aimed to develop and examine the aesthetic, bedtime story, connecting with nature, and drawing (ABCD), community based, program for grandparents to help them promote their grandchildren's development.

Methods

The action research was conducted in two phases. In the first phase, semi-structured interviews and focus group discussions were utilized to gather information from healthcare providers, teachers, and community leaders to develop the ABCD program. This was followed by a critical evaluation of the program's activities, materials, and contents. The second phase was to examine the program's effectiveness. A one-group pretest-posttest design was used to study the effectiveness of the program among 20 dyads of grandparents and grandchildren.

Results

All grandparents attended and completed the program. The grandparents' knowledge increased significantly (p = 0.024), and satisfaction with the program was high (X = 9, SD = 0.93) while children's development was not statistically different (p = 0.317).

Conclusion

The ABCD program was found to be feasible and acceptable to grandparents of skipped families to promote their grandchildren's development. The importance of healthcare providers, teachers, and community leaders in providing ABCD programs must also be recognized.

The Twelve Ds: An Update to Edwards and Benson's Reasons for Non-Parental Caregiving

This qualitative study examined the prevalence of the "Nine Ds," a framework developed by Edwards and Benson for understanding the heterogeneity of reasons for which grandparents assume care of grandchildren (i.e., death, disease, detention, divorce, departure, drugs, desertion, delivery, deployment) in a contemporary sample. Using a nationwide sample of custodial grandparents (N = 322) and foster parents (N = 105), caregivers were asked their reason for assuming care of the grandchild or foster child within their care. The results of the study suggest that the Nine Ds are a useful framework, but accounted for only 21.74% of responses, indicating the Nine Ds fail to capture many of the reasons for assuming care. Three new themes-dollars, duty, and daily grind-were identified using semantic thematic analysis and are applicable to both grandfamilies and foster families. These themes represent different motivations for assuming care and provide insight into the social structures that may act as barriers to family formation. This study provides a foundation for future research examining the impact of assumed care by non-parental attachment figures on the health and well-being of both grandchildren and foster children.

Mediterranean Diet Adherence in Community-Dwelling Older Adults in Spain: Social Determinants Related to the Family

The Mediterranean diet (MD), a well-established quality diet model, and regular physical activity are associated with reducing the appearance or progression of several chronic diseases and reducing morbidity and mortality. However, reduction of these goals, adherence to the MD, and regular physical activity occur at all ages, including older individuals in Mediterranean countries such as Spain, where at least adherence to the MD is culturally rooted. Objective: To evaluate the degree of adherence to the MD and physical activity in older individuals. Methods: The sample comprises 679 older adults aged 60 and over who attended activities in municipal centers for older adults in Valencia. Adherence to the Mediterranean diet, frequency of physical activity, and anthropometric assessment were used. Results: High adherence (score ≥ 9) to MD was observed only in 23.7% of the study sample. Smoking habits or having meals in fast-food restaurants on a weekly basis were significantly (p < 0.05) associated with lower MD adherence. Age, BMI, marital status, and physical activity were not significantly associated with MD adherence. Physical activity was significantly (p < 0.05) lower in individuals who were divorced or widow/ers and in those taking care of their grandchildren several times a week. Conclusions: Adherence to the MD in a big Spanish city is low among older individuals. Socio-family factors seem to play a role. Public health and governmental strategies should reinforce adherence to the MD among older individuals as a gold standard for nutrition.

Stepping Up and Stepping In: Exploring the Role of Nurses in Supporting Grandparents Raising Grandchildren

This study focused on the experiences of grandparents raising grandchildren in rural, Prince Edward Island, Canada. Termed grand-families, there are numerous reasons why grandparents must step up and step in to care for their grandchildren. Often these reasons are related to their adult children's struggles with mental illness and substance use disorders. Adopting Clandinin and Connelly's approach to narrative inquiry, we present findings from the conversational interviews conducted with 12 grandparents raising their grandchildren. Interview data were analyzed through the narrative dimensions of time, place, and relationship. Findings are presented as rich narratives which illuminate the evolution and storied experiences of grand-families. Particularly revealing are the challenges grandparents face as they navigate various systems, including health care, that do not acknowledge the uniqueness of their family form. Nurses work with grand-families across varied clinical settings. Grounded within the philosophy of Patient and Family Centered Care and family nursing theory, this article offers recommendations for supportive interventions that nurses can implement when caring for grand-families across clinical settings. This study has the potential to facilitate the development of evidence-based supports and services, which are responsive to the needs, realities, and complexities of grand-families.